| NPI | 1306923529 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TN PA01473) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MI 5601003272) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2009-06-18 |